Mon25October0844PM 11

A 67-year-old man is admitted to the resuscitation room of the Emergency department with clinical evidence of an non-ST elevation myocardial infarction (NSTEMI)

Immediately following admission he has a cardiac arrest and resuscitation commenced. The initial rhythm was pulseless electrical activity (PEA) but returned to a spontaneous circulation following four cycles of advanced cardiac life support. He remains sedated, intubated and ventilated.

What is the next appropriate step in his management?

(Please select 1 option)

Perform a chest X ray to check the endotracheal tube position Incorrect answer selected

Insert a nasogastric tube and give aspirin and clopidogrel This is the correct answer

Insert an arterial line

Administer thrombolytic therapy

Starting cooling to 33°C

Explanation

All these options would be appropriate in the context of managing his post-arrest care.

However, the first step should be to give aspirin and clopidogrel as this can usually be achieved quickly and easily in the resuscitation room whilst other investigations and treatments are organised.

Ultimately he would be discussed with cardiology to consider percutaneous coronary intervention (PCI).

Answer Statistics

1

7%

2

61%

3

11%

4

9%

5

14%

Times answered: 281